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new year

Fitness New Year’s Resolution Tips

The holidays were here and there was plenty of running around and parties to attend. As we said goodbye to this year, we are ready to take on the new year. Many individuals have decided to make fitness a resolution and made the commitment with themselves to get into better shape.

Many individuals do not plan for this transition and end up stopping within three months. There are some things you can do to be successful if fitness is on your list of resolutions.

The first thing you want to do is to choose a fitness facility where you feel comfortable. By comfortable I mean, do you like the atmosphere? Is the gym to big or small for you? When you look into fitness facilities, make sure they’re not too far from your home. If the gym is too far, you’re less likely to go consistently. Try to plan for when the best time would be to go. Decide if morning, afternoon or evening works better for you and your schedule.

When you find your gym and figure out a time, make an appointment for an assessment and consultation. There are some people who decide to do this after a couple months of joining. Try to see a fitness professional within the first two weeks. We are able to help you figure out a plan for your workout and keep you on track. Some fitness centers call new members after the first week to see how everything is going.

It’s also important to not have an “all or nothing” mentality. If you decide to go to the gym three days a week, but sometimes fall short, it’s OK! Just get back to your schedule the following week. It will take about three months to adapt to your new transition.

Another tip is to have fun! Look at class schedules and try new classes. If you are new to classes, don’t worry about keeping up with everyone else. I always suggest that clients show up to class ten minutes early. This enables you to speak with the instructor about any injuries or concerns you may have. You can also leave class early if you need to. Some new students may only be able to do a warm up and have to leave. Remember that everyone in the class was in the same boat as you at some point.

It may seem tough to add fitness to your life at first, but it will get easier. You will start to feel better overall. Many people are able to sleep much better, bring down their blood pressure and cholesterol, reduce stress, and prevent osteoporosis. The benefits are really endless! The best thing is that you are setting the stage for a healthy lifestyle as you get older. You will be able to do more and live independently longer.

Good luck to everyone this year who has fitness as one of their resolutions. You will be able succeed if you keep positive and plan for success. Have a happy and healthy new year!


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

Mirabai New Year Article

Health Coaching: A New Way To Keep Those New Year’s Resolutions

So you go to your annual check-up and your doc says “whoops your blood pressure is up and you’re 15 pounds heavier than last year. I’ll give you some meds, but you’ll have to lose weight and get into shape, OK?

You say OK, you walk out and then what?

Join a gym, hire a personal trainer, go on a diet, take a walk? You might do one or several of these because, after all, it’s a new year and a new you.

Right? Right, and you try something. But how long is it till you throw up your hands and say, “ugh, I got started and now I’m off the track just like last year.”

What went wrong? Maybe nothing, except you might not have been psychologically ready to take those steps.

For any change there is a process. One of the models that are used is the transtheoretical model of behavior change (TTM) developed by James O. Prochaska , Ph.D

There are 5 stages:

Precontemplation – going along not aware of a need for, or not wanting a change.

Contemplation – recognizing a need to do something to improve your situation and considering making some sort of change.

Preparation – doing some research, making small changes, or at least thinking about what you’re going to do to help yourself.

Action – Actively making lifestyle changes,

Maintenance – Having made changes, keeping the healthy lifestyle going.

All too often we jump from contemplation to action without being ready for the change. It can feel like getting off a plane in Antarctica wearing shorts and a T-shirt. You wanted to be there but you weren’t ready for what that change would be like, and what you’d need to do to stay there comfortably.

But there is help, a new kind of help.

The health and fitness industry is rising to the challenge of our increased involvement with our own health care.

Many of us still think of fitness professionals as muscle heads with great bodies and not much else. Those types will always exist, but more educational opportunities including degrees and certifications are spawning a new breed of health & fitness professional, one that’s part of the health as well as the fitness industry.

Enter the Health & Wellness Coach

Not to be confused with a personal trainer, the Health & Wellness Coach is a consultant who helps you go, through, preparation, to action and on to maintenance. The coach helps you determine your health and wellness goals and needs. Once you have a path to your goals the coach continues to work with you to help you find the behavior modifications, activities, facilities and allied health professionals (MDs, Ph.Ds, Nurse Practitioners RDs, PTs, Personal Trainers, Exercise Instructors, etc.) to support your healthy lifestyle. You can do this on your own, but having someone with health industry knowledge who has your back, who is nonjudgmental, who just wants to help you focus and succeed can make all the difference.


Mirabai Holland MFA, EP-C, CHC is one of the foremost authorities is the health and fitness industry. Her customer top rated exercise videos for Age-Onset health issues like Osteoporosis, Arthritis, Heart Disease, Diabetes & more are available at www.mirabaiholland.com. Mirabai also offers one-on-on Health Coaching on Skype or Phone. Contact her at askmirabai@movingfree.com.

ocean-hope-positivity

Living With Purpose: A Challenge Fear Can Sabotage

I find the holiday season to be challenging mentally, emotionally and physically. I am sure many of you who are reading these words feel a similar pressure of the current year ending – and the uncertainty of the new one to come. During this time of the year I have found myself being repeatedly burdened by entertaining old, worn out, negative thinking which leaves me exhausted and prone to getting sick, frustrated and fearful of the unknown time ahead.

The mind-body connection

This year it has been no different for me as I seem to be facing a past challenge regarding my belief in myself, my self-worth – and my purpose. For the better part of the last week and a half I have been struggling with a bad case of what I believe is the flu. With this latest (rare) bout of illness I have been blessed with a large dose of coughing, sneezing, general weakness and a very substantial lethargy. I believe in the power of the mind to bring us health and well-being but I also believe our thoughts (and beliefs) can – and do – deliver to us the other side of life which includes illness, unease, a genuine lack of self-confidence, and a sense of what I will call “hopelessness” – a feeling of living without purpose.

This is how I have started to feel in December – that regardless of what I have done, written or spoken about in terms of my passion for healthy aging, that it matters little and that I am wasting my time. This thought has occurred to me many times before and I am sharing it with you now because I am going through this challenge in this moment in time. ALL of us at some point in our life (and in my case it has been more than once) have felt empty inside and afraid – fearful of the unknown, of not being enough, of having chosen our path in life badly – and much more “baggage” that we carry around with us every day! It is a burden we decide to carry. It is up to each of us to decide to stop carrying this extra weight – or it will remain a “drag” on our life well into the future! We don’t need negative thought patterns ruining our lives, do we?

Fighting negative thoughts

The point is that it takes courage and discipline to “fight” this negative “wave” of feelings and thoughts. The first step that we can take to address this important issue is to become AWARE that it is happening – and to STOP and THINK in order to increase the possibility of changing your mind in order to “reassert” your power over your training – but your life as well. I am grateful for these reminders as they spur me to make the choice again that I AM valuable and worthy of success. Even at 70 I am dealing with this very issue as Christmas approaches – again. I had a terrible Thanksgiving because I could not be with my daughter and grandson and tonight had a harsh exchange of words with her over the phone (frustration, anger, fear – whatever it may be.)

What this matter basically comes down to is a FIRM belief in ourselves – and our own unique purpose – that we are alive for a reason. It is incumbent upon each of us to maintain a vigilant and forceful awareness that CAN prevent negative thoughts from derailing our dreams from becoming fully realized. If we allow these negative thought patterns to remain in our subconscious minds over time they WILL harm us emotionally, mentally and physically. ALL life – and reality – begins with thought, so guard your thoughts well! I am sorry to report that we are never done with these challenges of the mind and they can – and DO repeat (sometimes – not always) for a reason: To REMIND us of who we are – and are becoming. The ego wants to regain control of our thought patterns and return us to an earlier status quo that never worked for us – and never will.

The antidote for this negative “cycle of thought” is an examination of what we are doing and how well we are doing it. Can we improve our behavior? Our discipline? Our planning? Our listening? What is it that we are seeing again – and why? My conversation (argument) with my daughter showed me I am still capable of entertaining past negative thinking with poor results showing up again in my life. What a DRAG! Low self-worth and self-esteem can raise doubt and fear in all of us. What I am experiencing right now is a reminder of the road I have travelled – and the miles I have to go. It is always incumbent upon each of us to be “self aware” and allow this awareness to guide us to take personal responsibility for our behavior – and thoughts – (all that any of us can control  and then, and only then, will we make it successfully to our goal and accomplish our mission.

Our fitness programming follows this same logic and if we believe we cannot make it – we won’t. Our thoughts determine our results and our belief systems determine everything else of importance in our lives. DON’T LET FEAR AND SELF DOUBT control your future destiny. DO NOT entertain thoughts that in and of themselves are self destructive. I don’t know how the distance with my daughter will be bridged before Christmas but it will probably include compromise and some serious mutual listening.

Conflict in itself solves NOTHING but it CAN promote growth and understanding so I am not shy about engaging in a good argument – if it leads to greater mutual understanding – and peace. It is in HOW we disagree that matters. I argue with my feelings leading the way sometimes and that CAN be hurtful, but in this hurting we may get the opportunity to expand our definition of ourselves – and expand our consciousness as well. This is what I would call a “win – win”. This potential outcome CAN help us grow into a new definition of ourselves and create new opportunities with those we love – and with those others we value in our lives. It is about taking some risk and exposing ourselves to being uncomfortable for a while. I feel it is worth the effort – just be smart about how you go about implementing this idea!

I am convinced this time of year is challenging for all of us because there is much we need to learn – not only about ourselves – but about each other as well. After 45 years of being a father I am still learning about what that means and tonight I found out I am still NOT as patient or compassionate as I thought I was and so some “soul searching” will be required to bring me back to my best path of growth and understanding with those I love.

Take time today to reflect not only on your relationship with yourself but also with those you love and care about and see what emerges. You might be in for some amazing surprises and only YOU can do this work. Becoming a thoughtful listener is really the key to effective communication so practice that skill a lot! We have TWO ears and ONE mouth for a reason. I really find the holiday season to be about buying “STUFF” and not about appreciating our many blessings. This thought drives me crazy! However, this is the life we are living today so I either learn to live with it creatively or I will continue to hit the same “brick wall” as I have in the past – and I CHOOSE NOT DO THAT. All of this is to say that becoming unsettled, confused – or even angry – is probably a sign that we ARE ready for positive change to enter our lives and I TRULY BELIEVE that is a VERY good thing! Travel well.

Originally printed on HealthyNewAge.com. Reprinted with permission from Nicholas Prukop.


Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

If you need help in designing a fitness plan, you can contact Nicholas Prukop via email at runningnick@sbcglobal.net or read his inspiring book Healthy Aging & YOU.

Doctor Examining Male Patient With Knee Pain

Restoring Movement and Mobility: The fitness professional’s role in total joint replacement care

According to the American Joint Replacement Registry, there are 860,000 total knee and hip replacements done in the United States per year. This number is projected to double in the next ten years. There are more knees than hips done per year and more females have these joint replacements than males.

According to Mike Carberry of Advanced Medical Integration, “Regenerative medicine is one of the most talked about subject healthcare has ever known; and for good reason. It could hold the solution to the puzzle of America’s failed healthcare system.”

This is wonderful news for the personal training industry. Insurance is paying for less and less, costing more while the number of consumers seeking optimal health is increasing. A perfect storm in the making!

A personal training certificate, however, is not enough to appropriately deal with the typical client with total joint needs. Specialization in anatomy, joint physiology, biomechanics and therapeutic exercise are necessary in order to adequately and appropriately manage total joint conditions. These skills and techniques in conjunction with medical communication skills will give physicians confidence to send these patients to the appropriately skilled personal trainer. Spending time with a physical therapist and surgeon specializing in these areas will go a long way in establishing confidence, trust and credibility in handling the client with total joint conditions.

Most individuals with true joint pain have some level of osteoarthritis. Approximately 27 million Americans suffer from degenerative joint disease (also known as degenerative arthritis or osteoarthritis). Degenerative joint disease is the most common chronic condition of the joints and occurs most often in knees, hips, lower back and neck, small joints of the fingers, and the bases of the thumb and big toe.

Osteoarthritis is the most common form of arthritis that causes a breakdown of joint cartilage, and it affects mostly middle-aged and older adults.

Although there is no cure for osteoarthritis, the good news is that it can be helped, and quality of life maintained by implementing and maintaining some simple changes in daily life. Regardless of the intervention, from routine steroid injections to platelet rich plasma/stem cell treatments to total joint replacement, here are a few areas where the personal trainer can intervene with great success.

Exercise

Exercise is key component of arthritis care, exercise strengthens the muscles, lessens joint pain and stiffness and improves overall health. Types of recommended exercises may include strengthening, aerobic activity (aquatic activity is wonderful), range of motion or stretching activities and balance exercises.

Joint protection

Protect the joints to ease pain and avoid further damage. Make sure to balance rest with activity as well as know when to stop. A good rule of thumb is to adjust down the frequency, intensity and duration by 50% of what a “normal” client can do or what the client thinks they can do. Remember these clients are typically deconditioned relative to strength and cardiovascular fitness. They will not handle the all-too-popular high-intensity interval training (HIIT). This population will succumb to overload and may be injured.

Pain control

Pain control routinely treated with prescription or over-the-counter medications can be replaced or augmented by relaxation techniques (yoga, Tai Chi, meditation and massage) along with application of heat, cold and/or vibration.

Post-procedure care

If the client has had regenerative therapy or a total joint replacement, they will need a specific post-procedure plan to allow for healing/protection, early intervention and return to activity function. Hopefully, they had pre-intervention care inclusive of appropriate exercise, nutritional counseling and insight on what to expect with the procedure and post-procedure care. Appropriate nutrition for optimal health and healing along with hydration techniques and insights are a must during these sessions.

Phase 1: Post-procedure care

Typical post-procedure care is in three to four phases. Phase one is protect/rest, restore and control pain. During this phase the focus is on mediating pain, restoring range of motion, controlling swelling and protecting the joint. This is typically fourteen to twenty-one days in duration. Stitches or staples are usually removed at this time and scar management can commence around the twenty-first day.

Phase 2: Post-procedure care

Phase two is the restore and regenerate phase. The

wound is healing (healed), the joint and soft tissue healing continues, and remodeling of tissue has begun. This phase is typically three to six weeks in duration. Techniques to restore range of motion and other soft tissue techniques to facilitate healing according to tissue physiology and the client’s general health are initiated (conditions such as diabetes, obesity, cardiovascular disease and others will alter the healing and remediation phases). Techniques for ambulation, gait and balance are initiated along with appropriate cardiovascular conditioning.

Phase 3: Post-procedure care

Phase three typically commences when the client has gained full range of motion, has good balance and gait mechanics and is able to tolerate closed-chain activities for both upper and lower extremity movement patterns. This phase is the final phase and progresses to full functional activity and return to sport or recreational activities of choice (these activities may be placed into a fourth phase). During this phase it is incumbent upon the personal trainer to load appropriately and have working knowledge of the mechanics of the sport or recreational activity. There are some tremendous resources available for this purpose.

Complications

Complications to be aware of when working with these patients include but are not limited to infection, blood loss, dislocation, blood clots and fatigue. The personal trainer should also be in contact with the client’s physician and physical therapist if one has been engaged. These are medical conditions requiring communication and conservative care.

Most physicians like to know who is working with their patients and appreciate the communication for optimal outcomes. The insightful and knowledgeable personal trainer with the right training can be an invaluable member of the total joint care team. The future is bright!

This information is provided as an overview and in no way should be interpreted as a protocol for treatment or otherwise. Our goal is to inform the reader on opportunities in the profession and stimulate further investigation.

This article was featured in MedFit Professional Magazine fall 2019 issue.

Subscribe to MedFit Professional Magazine to read more great content like this!


Dr. Stephen A. Black is a sports medicine specialist, author and clinician. His doctoral degree is in sports medicine and he holds degrees in physical therapy, athletic training and certification through the National Strength and Conditioning Association. Dr. Black has over forty years’ experience in patient care and practice management. He lectures frequently on topics in sports medicine, works with professional, Olympic and youth athletes and holds several academic appointments. Visit his website, rockymountainhpc.com

Nutrition concept in tag cloud

Sports Nutrition Updates

Sports nutrition was a hot topic at this years’ annual Food & Nutrition Conference & Exposition (FNCE), hosted by the Academy of Nutrition and Dietetics, the nation’s largest group of nutrition professionals. Here are a few highlights, to keep you up to date with current sports nutrition recommendations.

Performance enhancers

  • Sport supplements that promise improved performance are always tantalizing. If they make as little as 0.5 to 1% improvement, the supplement is deemed to “work.” While scientists want well-controlled research studies to prove effectiveness, athletes respond very quickly to anecdotes—and often spend lots of money on what might be just a glimmer of hope. (In the four months leading up to the Olympics in 2000, one athlete spent $3,480 on supplements!)
  • The Australian Institute of Sport is creating a website for grouping supplements according to effectiveness: Group A (proven to enhance performance), Group B (deserves more research), Group C (little proof of meaningful benefits) and Group D (Banned).  Check it out at www.ais.gov.au/nutrition/supplementsThe helpful information can help guide your supplement choices.

Vitamin Zzz, aka Sleep

  • Sleep is one of the best performance enhancers. Lack of sleep has detrimental effects on performance. Athletes with good sleep quality are able to train harder, recover faster, and perform better. And take note:  if you think you can drink coffee at night and still sleep fine, think again. Brain wave studies suggest otherwise…
  • How much sleep is enough? More than 6 hours a night. Very few athletes can perform well with less than that. Top athletes commonly strive to get 8 to 10 hours of sleep each day, including a nap between 1:00 and 4:00 pm. (A later nap results in poorer sleep that night). Teens should target 8 to 10 hours and adults 7 to 9 hours. Lack of sleep can significantly impact your diet. After two nights with only 4 to 5 hours of sleep, the appetite increases about 20%. You’ll likely find yourself snacking more than usual (on fatty foods), eating fewer fruits and veggies, and consuming ~385 additional calories. Yikes!
  • For good sleep information, visit centreforsleep.com and take the Athletes’ Sleep Screening Questionnaire. Athletes who understand the benefits of sleep tend to sleep about 20 minutes more. I hope this holds true for you!

Muscle building tactics

  • When it comes to building muscle, you want to surround your workout with food, so you can get the most benefits from your efforts. Intermittent Fasters, take note: if you lift weights in a fasted state (without having eaten any pre-exercise fuel), the muscle-building effect of exercise is not enough to out-weigh the muscle breakdown that happens in a fasted state. Eat before you train!
  • Many athletes assume if they fail to eat within 45 minutes of lifting weights, the anabolic  (muscle-building) window slams shut. Wrong. Refueling either 1 or 3 hours post-exercise generates a similar gain in muscle protein synthesis. For the average exerciser, the effect of post-exercise protein timing on muscle growth is relatively small. For competitive body builders, the gain is also small but perhaps meaningful, so most prefer to err on the side of caution.
  • Consuming post-exercise protein stimulates insulin secretion, as does carbohydrate. (Did you know that whey protein stimulates more insulin than white bread?) Insulin reduces muscle breakdown and enhances glycogen replacement. Refueling with a combination of protein + carb is best for athletes who do two-a-day workouts, to optimize glycogen replacement. Athletes who do only one workout and refuel with a sports diet based on grains, starchy vegetables and fruits can replenish depleted glycogen stores over the course of 24 hours.
  • Does eating extra protein build bigger muscles? The body incorporates only a limited amount of protein into new muscle tissue. Spacing out protein intake by consuming 20 grams of protein every 3 hours (four times a day) is preferable to eating 80 grams in one dose. More specifically, athletes want to target 0.2-0.25 g pro/lb. body weight (0.4 to 0.55 g/kg) four times a day. This target varies from person to person. Vegans, for example, will want to consume a higher amount to get adequate leucine, an amino acid that triggers muscle growth.

Eating disorders in male athletes

  • Eating disorders (EDs) are not just a female problem. About 9% of male athletes—as compared to about 21% of female athletes—struggle with food issues and restrict their food intake to lose undesired body fat. The lack of fuel available to support normal bodily functions impacts bone health and reproductive function in men, just as it does in women. In men, low energy availability can lead to low testosterone, poor semen quality, reduced sperm count, and slower sperm motility. In women, it shows up as loss of regular menses (amenorrhea), hence infertility.
  • Compared to female athletes, male athletes can withstand more of a severe deficit before the appearance of symptoms such as low testosterone, bone stress injuries, and reduced bone density/poor bone health (osteoporosis). To reverse the energy deficit, athletes need to boost their energy intake, which can be easier said than done for those struggling with eating issues and fears of “getting fat.” One way to consume the recommended 350 additional calories per day is to break two energy bars into small bites, and nibble on them over the course of several hours. Men seem to be able to reverse the hormonal imbalance within days, while women can take months. Reversibility of bone density is not guaranteed.

Keto diet

  • A ketogenic sports diet (moderate protein, very low carb, very high fat) appeals to some athletes. Yet, we need more research to understand the fine details of adaptation to the keto diet and the role of keto supplements. (Supplement sales vastly exceed the science!) Stay tuned; perhaps we’ll have more answers from next year’s FNCE!

Reprinted with permission from Nancy Clark.


Sports Nutritionist Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). The new 6th edition of her best selling Sports Nutrition Guidebook addresses today’s questions and concerns about what to eat. For more information, visit NancyClarkRD.com. For her online workshop, visit NutritionSportsExerciseCEUs.com.

wine-glasses

Alcohol and Your Health – Cheers! or Not?

Depending with whom you speak, alcohol can be a villain or it can be a hero. We have long known that alcohol can help reduce the stress of everyday life, and even relaxes our most tightly wound friends and associates. Recent data also suggests that fairly regular alcohol ingestion is actually good for your heart. This is probably one of the reasons that many European countries, where wine is a normal part of everyday life, have significantly lower rates of heart disease despite relatively high fat diets. The protective effects may come from substances called flavonoids and also antioxidants that are found in alcohol, especially wine. It also can increase HDL levels (the good cholesterol) and lower the risk of blood clots by slightly “thinning” your blood (anti-platelet effect). Red wine also has resveratrol, a compound that has been shown to possibly reduce lung damage in patients with chronic bronchitis and emphysema, by lowering levels of interleukin 8, a chemical that causes lung inflammation. It has also been touted to have life extension (i.e. longevity) and disease fighting capabilities but more research is needed.

Too bad it’s not that easy, i.e. “drink to your heart’s content.” There is a dark side. Even the American Heart Association cautions people NOT to start drinking if they do not already drink alcohol. For many, alcohol can be deadly. It can be a cellular toxin, with brain cells and liver cells particularly susceptible. Alcoholism is a serious disease, with some predisposed from a genetic standpoint. For them, there is no safe amount. It is also never safe or recommended during pregnancy because of the harm it can cause to the developing baby. Alcohol can be dangerous for those with certain medical conditions such as diabetes and liver ailments and also has been implicated in the development of certain cancers. Also many alcoholic beverages pack a significant amount of calories which contribute to obesity risk and much of the obesity epidemic.

Alcohol also kills when mixed with driving. I believe we will see tighter restrictions regarding the legality of drinking and driving especially in terms of acceptable blood-alcohol content. Recent scientific data suggests that we actually loose coordination as well as other important motor and cognitive skills essential for safe driving, even while we are within the legal limits of blood alcohol levels. The National Highway Traffic Safety Administration, in conjunction with The University of Iowa, is doing research on driving under the influence using a three ton, $81 million DUI simulator. This simulator puts the drunk driver in “real life” road situations using high resolution 3-D images, and monitors reaction times and other motorist behaviors. Hopefully studies like this will help provide safer guidelines for us. I am fairly certain that study will have no trouble finding volunteers. There are even commercially available simulators (drunk driving and texting while driving) for educational purposes.

Being an orthopedic surgeon, who has spent plenty of time in the ER, I can state without hesitation that impaired driving kills, and kills many, dramatically changing lives (even innocent ones), be it alcohol, marijuana, or other drugs. Ditto for cell phone distracted driving. All preventable.

So, what is the right answer for you in terms of alcohol? The key, like so many other things in life, is balance and moderation. Weighing risks with rewards and being responsible, not only to yourself, but to those around you.

Poison or potion? It is up to you. Remember, moderation is the key. Check with your doctor to see if there is a place for alcohol in your path to better health.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.


Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA